Tuesday, February 24, 2009

Ethics and Evidence

angry doc received the form for the Ministry's "Knowledge, Attitudes, Beliefs and Practices Survey on HIV Infection and AIDS (2009)" in the mail today, and as you can see from the photo above (angry doc does not own a scanner) the last question in the survey is quite a poser.

On the surface the question may look like one of ethics (or worse, morality), but in reality it is more one of legalities - and the two may not always be the same.

angry doc believes that the question is left deliberately vague as it is meant to assess the respondent's attitude and belief rather than his or her knowledge - there isn't enough information about the young doctor's job to determine if his status does indeed "impact on his work".

The cover letter to the survey states that the purpose of this survey is to help "refine and enhance our national HIV prevention and control policies". While angry doc is flattered to have been invited to respond (along with all "registered doctors, dentists and nurses in Singapore"), he wonders if policies, which will no doubt translate to laws and code of ethics, should be determined by the attitudes and beliefs of the healthcare workers, or whether they should be guided by what we know about HIV and its transmission.

angry doc invites all healthcare workers who have received the survey form to read through it and note their responses to the questions, and then read this article, and see if their responses change.

The legalities of patient confidentialty are summarised in this article:

http://www.sma.org.sg/sma_news/3211/council.pdf

The Private Hospitals and medical Clinics Act also states that:

16. If any person discloses to any other person any information obtained by or given to him in pursuance of this Act he shall, unless the disclosure was made in the performance of his duty, be guilty of an offence and shall be liable on conviction to a fine not exceeding $5,000.